Following the recent increase in dearness allowance (DA), the Central Government has now made a revolutionary change to the Central Government Health Scheme (CGHS). Effective October 13, 2025, package rates for approximately 2,000 medical procedures have been revised. This historic decision will greatly benefit millions of central government employees and pensioners, as they will no longer have to spend large sums out of pocket for treatment, and cashless treatment will be fully ensured.
Why was cashless treatment not Available
For a long time, employees and pensioners had a serious complaint that CGHS-accredited hospitals flatly refused to provide them with cashless treatment. Patients were forced to pay for the entire cost of treatment out of their own pockets and then wait for months for reimbursement. Hospitals claimed that the government-fixed rates were outdated and far below the actual cost. Additionally, they were not receiving timely payments, which made them unable to provide cashless services to CGHS cardholders.
Choice Rate Changes
The central government has now taken the complaints from hospitals seriously and revised the new rates on a scientific basis.
New Rates
Under the new reforms implemented by the government, new rates have been determined based on the category of hospitals and cities.
NABH-accredited hospitals: These will be paid at the base rate.
Non-accredited hospitals: These will be paid at a rate 15% lower than the base rate.
Super-specialty hospitals with more than 200 beds: These will be paid at a rate 15% higher.
City-Based Rates
Rates in Tier-II cities have been set 19% lower than the base rate, while rates in Tier-III cities will be 20% lower. This classification ensures fair and profitable rates for hospitals.
Patients will receive significant relief
The primary objective of these amendments is to provide hospitals with fair and profitable rates, enabling them to provide cashless services to CGHS beneficiaries without hesitation. This will eliminate the hassle of patients making advance payments and eliminate the complex compensation process. Currently, this facility is available in approximately 80 cities under CGHS, directly benefiting over 4.6 million central government employees, pensioners, and their families. This major step strengthens health security for government employees.